MARK A ANTONACCI MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****55

License Status

ACTIVE

Business

Title

First Name

MARK

Middle

Last Name

ANTONACCI

Business Name

MARK A ANTONACCI MD

Original Issue Date

10/23/2018

Effective Date

04/09/2023

Expiration Date

07/31/2026

City

SAN ANTONIO

State

Zip

78260

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

04/09/2023